Look back in anger?

Look back in anger?The past 11 months have seen HIV/AIDS assume the spotlight in South Africa as never before. However, despite all the meetings, protests and discussions, people have continued to die from AIDS-related symptoms and the numbers of AIDS orphans and HIV positive babies have continued to climb. In this article, we take a month by month look at AIDS in South Africa in 2000.

The past 11 months have seen HIV/AIDS assume the spotlight in South Africa as never before. However, despite all the meetings, protests and discussions, people have continued to die from AIDS-related symptoms and the numbers of AIDS orphans and HIV positive babies have continued to climb. In this article, we take a month by month look at AIDS in South Africa in 2000.

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January

The South African National AIDS Council (SANAC), a multi-sectoral body designed to advise government regarding HIV/AIDS is launched. Loaded with government officials, the panel is criticised by the press, the opposition and the non-governmental sector for its exclusion of scientists, clinicians and AIDS activists.

February

The 2000-2001 Budget allocates an extra R75 million to AIDS.

The bulk of this (R58 million) goes to HIV prevention rather than care despite the increasing strain which HIV/AIDS is placing on the health system.

March

AIDS dissident David Rasnick divulges that he has been in communication with President Thabo Mbeki regarding the link between HIV and AIDS.

The Human Rights Commission rules against the Blood Transfusion Service’s “unconstitutional barring” of healthy gay men from donating blood.

April

The 1999 antenatal survey indicates that 22.4% of pregnant women are HIV positive. The Department of Health estimates on this basis that 4,2 million people in South Africa are HIV infected and argues that the epidemic is stabilising.

President Mbeki writes to President Bill Clinton, the United Nations and the WHO defending his right to question the link between HIV and AIDS.

Pfizer announces that it will donate Fluconazole to AIDS patients’€“ but the offer turns out to be limited to cryptoccocal meningitis, an extremely rare disease.

May

The International AIDS Panel, invited by President Mbeki to discuss the link between HIV and AIDS, meets in South Africa.

Labour Minister Membathisi Mdladlana launches a draft code of good practice to help ensure that workers with HIV are not discriminated against in the workplace.

South African Airways offers a R100 000 settlement for refusing to employ a man because of his HIV positive status.

At the Parliamentary Portfolio Committee’€™s public hearing on HIV/AIDS, activists argue that the pharmaceutical industry can easily afford to lower its drug prices in the developing world and that there is a legal obligation on government to use the Patents Act to ensure lower drug prices via compulsory licensing.

June

The 5-year HIV/AIDS & STD strategic plan, designed to guide the country’€™s response to the epidemic, is launched by the Department of Health. The plan is based on the assumption that HIV causes AIDS.

MEC for Health in the Western Cape, Nick Koornhof announces that the Democratic Alliance–led province will introduce the anti-retroviral drug AZT for HIV infected pregnant women despite the fact that the National AIDS plan does not allow for the provision of anti-AIDS drugs.

UNAIDS releases a report stating that SA has the worst HIV epidemic in the world and that about half of all 15 year old boys in the country will develop AIDS during their lives.

July

South Africa hosts the XIIIth International AIDS Conference in Durban. Despite fears of a boycott to protest President Mbeki’€™s AIDS stance, over 12 000 delegates came to the first International AIDS Conference to be held on the continent worst hit by the epidemic.

Presidential spokesperson Parks Mankahlana states that the Durban Declaration, which affirms that HIV causes AIDS and is signed by more than 5 000 scientists, belongs in the dustbin.

The South African Intrapartum Nevirapine Trials (SAINT) show that HIV transmission from mother to child can be cut by at least one third from a single dose of Nevirapine. Boehringer-Ingelheim offers to provide Nevirapine free of charge for five years to prevent mother to child transmission.

August

The AIDS Law Project wins its case against SAA regarding discriminatory pre-employment HIV testing.in the constitutional court,

September:

Radio talk show host, John Robbie, tells the Minister of Health Manto Tshabalala-Msimang to “go away” when she declines to say whether she believes that HIV causes AIDS during a live interview.

The Congress of South African Trade Unions (Cosatu) asks President Mbeki to acknowledge the link between HIV and AIDS.

Mbeki agrees in Parliament that the debate on the cause of AIDS has undermined the central messages of government’€™s anti-AIDS programme, but continues to question the link between HIV and AIDS because “a virus causes a disease and not a syndrome”.

Former president Nelson Mandela states that he believes HIV to be the cause of AIDS.

October

The ANC denies that President Mbeki allegedly told the ANC MP caucus that the Treatment Action Campaign, a lobby group for the provision of anti-retroviral drugs, is funded by drug companies and has “infiltrated” the trade unions.

The Medical Reasearch Council announces that it will soon begin clinical trials and hopes to make a vaccine against HIV generally available by 2005. The 2005 target is criticised by those who argue that it is unrealistic and raises premature hopes of a cure.

Health Minister Manto Tshabalala-Msimang acknowledges that the national and provincial parliamentary medical aid scheme Parmed provides members with access to anti-retroviral drugs at taxpayers expense – despite the fact that government will not provide these drugs at public hospitals.

At the second anniversary of the Partnership against AIDS campaign, Deputy President Jacob Zuma urges men to act more responsibly in the fight against HIV/AIDS.

The opposition Democratic Alliance kicks off its campaign for the December local elections with a promise to provide free anti-AIDS drugs in wards which it wins. This is despite the fact that the provision of anti-retrovirals is not a local competency and is determined at provincial level.

The African National Congress spokesperson Smuts Ngonyama accuses the Democratic Alliance-run Western Cape government of using black AIDS patients in Khayelitsha as guinea pigs by giving them dangerous and toxic drugs reminiscent of the biological warfare of the apartheid era. In fact, the Khayelitsha project was conceived under the leadership of Health MEC Ebrahim Rasool, now head of the ANC in the Western Cape.

Dr Nono Simela, head of the health department’€™s directorate for HIV/AIDS and STDS, announces that pilot programmes to prevent mother-to-child transmission of HIV would soon begin. “The department of health can take up the challenge,” she said. “Watch this space.”

Treatment Action Campaign organiser, Zackie Achmat brings 3 000 generic Fluconazole capsules manufactured in Thailand into the country in protest against the high cost of patented drugs. (Achmat bought the tablets for R1,78 each; in South Africa the state pays the manufacturer Pfizer R28,57 a tablet, and the private sector pays R80,24.)

Judicial Inspectorate Secretary Gideon Morris states that by sending a person to prison, you are effectively sentencing him to death from HIV transmitted via rape. A prisons’€™ monitoring group says that 90% of the 1 000 natural deaths in prisons so far this year are attributable to AIDS.

AIDS Treatment guidelines that emphasise the treatment of opportunistic infections, but include no plans to provide anti-retroviral drugs, are released by the Department of Health.

Rumours surrounding the cause of death of presidential spokesperson Parks Mankahlana result in a heated public debate regarding whether the government should inform the public when a senior government official dies of an AIDS-related disease.

The Intergovernmental Fiscal Review tabled in parliament states that in some provinces, 40% of patients in medical wards are HIV positive and that AIDS poses a significant risk to health budgets in the public sector. But the medium term policy statement shows that the specific allocations for HIV/AIDS have not been increased and remain at R150 million for 2001/02, despite the fact that additional funds are available in the fiscal framework.

November

Nelson Mandela states that government should provide anti-AIDS drugs to prevent mother to child transmission of HIV.

The Medical Research Council releases a mortality study which concludes that more than half the deaths of people aged between 15 and 49 are already HIV/AIDS related. Rising mortality rates are most marked in women aged 25-29 where rates are now more than triple what they were a decade ago.

A survey conducted by the Medical Research Council finds that 56% of truck drivers in KwaZulu-Natal are infected with HIV.